• 말소리와 음성과학
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• 제3권3호
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• pp.133-140
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• 2011

Muscle misuse dysphonia (MMD) is defined as a behavioral voice disorder resulting from inappropriate contractions of intrinsic and/or extrinsic laryngeal muscles. The purpose of this study was to investigate the effect of motor learning guided laryngeal motor control therapy (MLG-LMCT) which is designed to improve an existing LMT and further the effective voice treatment on people with muscle misuse dysphonia. Forty-six people with MMD (M:F=16:30) participated in this study. The voice samples of the participants were recorded to investigate the effect of MLG-LMCT before and after the voice therapy. Voice samples were analyzed via electro-glotto-graph (EGG). Contact quotient (CQ), speed quotient (SQ), and waveform were reported. In addition, perceptual and acoustical evaluation were conducted to determine the change of voice improvement after treatment. The experimenter massaged the tensioned muscles around the neck. In order to find more proper phonation the experimenter showed the subjects their EGG wave forms as to whether or not they are moving the vocal folds to the appropriate position. Therefore, the EGG wave forms were used as a type of visual feedback. With the wave form, the experimenter helped subjects move the vocal folds and laryngeal muscles to find more proper voice production. The sensory stimuli from the experimenter gradually faded out. A paired dependent t- test revealed that there was significant differences in CQ between pre- and post-therapy. Perceptually, overall, rough, breathy, strain, and transition were significantly reduced. Acoustically, there were significant differences in Fo, jitter, shimmer, and NHR. After using MLG-LMCT, most of the subjects showed improvements in voice quality. The results from this study led us to the following conclusions: Motor learning guided laryngeal motor control therapy (MLG-LMCT) has reduces muscle misuse dysphonia. These results may occur because a visual feedback from EGG wave form can maintain the effect of the muscle tension reduction from laryngeal manual therapy. In case of people with MMD who reduced muscle tension from the therapy (LMT) but, not appropriately manipulating the location of larynx or adducting the vocal folds, MLG-LMCT might be an alternative therapy approach.

• 한국콘텐츠학회논문지
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• 제16권12호
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• pp.327-345
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• 2016

본 연구는 인간발달 과정을 신경과학, 심리학, 운동학습, 근육 생리학 등의 행동과학 자료와 생체역학, 인체운동 분석, 운동조절 기반의 인지 동작치료 프로그램을 정서 행동장애 아동들에게 실시하여 표정에 따른 얼굴 움직임이 감정과 정서변화에 따라 어떤 특성을 갖는지를 표정 움직임의 변화로 정량화 하고자 하였다. 본 연구에서는 영상측정 및 키네마틱 분석의 정서 행동장애 아동의 표정변화를 중재 프로그램 피드백 자료로 활용하였고, 표정 변화를 통해 인지동작 치료프로그램 효과를 알 수 있었다. 또한 정서 및 행동치료의 영상분석과 키네마틱 분석의 정량적 데이터를 통하여 인간발달에 대한 융 복합적 측정 및 분석법을 적용하여 발달장애의 조기발견과 치료과정에 따른 데이터를 축적하는 것도 기대할 수 있었다. 따라서 본 연구의 결과는 아동뿐만이 아니라 자기표현이 부족한 장애와 노인, 환자에게도 확대 적용할 수 있을 것이다.

• 한국전문물리치료학회지
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• 제23권3호
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• pp.29-39
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• 2016

Background: In the treatment of temporomandibular joint (TMJ) disorder, the goals of traditional physical therapy are not only to reduce the inflammatory process leading to pain, but also to decrease joint overload and muscle hyperactivity. To achieve those goals, physical therapists generally use a photo-therapy, joint mobilization, and massage. Objects: To examine the impact of an unloading technique using non-elastic taping on the pain, opening mouth, functional level, and quality of life in patients with TMJ disorder. Method: Twenty patients with TMJ disorder were included in this study and randomly divided into the experimental ($n_1$=10), and control ($n_2$=10) groups. Traditional physical therapy including massage and stretching for 30 min was performed in both groups. Non-elastic taping was performed in the experimental group after traditional physical therapy, and they were recommended to keep the tape attached for 12 hours. Outcomes for pain, functional level, and quality of life were measured using a survey. The opening mouth was measured using a general ruler. Result: Significant differences were observed in the pain level, opening mouth, functional level, and quality of life after the intervention and on follow-up in both groups. However, we found that while the levels of all parameters were maintained throughout the follow-up period in the experimental group, the functional status level was not maintained throughout the follow-up period in the control group. Conclusion: Our unloading technique using non-elastic tape results comparable to those achieved by traditional physical therapy in the treatment of TMJ. However, the unloading taping method using non-elastic tape is more effective than traditional physical therapy in maintaining the impact of intervention.

• 수면정신생리
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• 제1권1호
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• pp.99-106
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• 1994

The authors report a case of REM sleep behavior disorder which occurred in a 69-year-old business man. He began experiencing episodic "acting out" behavior of his dream at the age of 66. The episodes tended to be associated with dream contents, mainly being chased or threatened. Before that, his sleep was relatively quiet despite occasional nightmares, midsleep arousal, and shallowness. Injuries resulted from leaping out of bed, jumping onto furnitures, and grabbing and biting the spouse's arm. Most recent dream-incurred laceration of chin required 5 sutures. Medical and psychiatric history revealed no significant findings except that he had been overanxious all his life within himself with others' reputation of himself as pleasant and easy-going. A nocturnal polysomnogram showed repeatedly intermittent increase of chin and/or leg muscle tones during otherwise characteristic REM sleep period. The overnight video recording revealed head lifting and limb movements during REM sleep periods. Brain MRI and EEG were normal. Job-related stress was presumed to be an etiological possibility. Clonazepam 0.25-0.5mg nightly almost completely relieved the symptoms.

• 대한통합의학회지
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• 제7권4호
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• pp.1-11
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• 2019

Purpose : This study was aimed at investgating the effect of McKenzie exercise on temporomandibular joint disorder (TMJD) and body balance. Methods : Thirty subjects with TMJD were selected. They were randomly assigned to one of two groups (15 in each group) : namely the conservative treatment group and McKenzie exercise group. The conservative treatment group were treated physical therapy for 6 weeks (3 times a week). The McKenzie exercise group performed McKenzie exercise for 6 weeks (3 times a week). We measured mouth opening, pain, muscle activation and body balance before and after exercise by using the maximum mouth opening MMO), visual analog scale (VAS), electromyography and Biodex Balance System, respectively. Results : We found statistically significant differences in pain and mouth opening in the conservative treatment group and McKenzie exercise group before and after (p<.05). Conclusion : We confirmed the effect of McKenzie exercise on TMJD. Thus we thought these results could be used as basic data and reference for TMJD. But we need more study effect of McKenzie exercise on TMJD and body balance.

• Journal of Oral Medicine and Pain
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• 제43권4호
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• pp.147-151
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• 2018

Disuse atrophy involves gradual muscle weakening due to inadequate usage and can cause temporomandibular disorder (TMD). A 45-year old man with TMD symptoms on the left side, who had disuse atrophy of the masticatory muscles on the right side following surgical removal of a trigeminal schwannoma on the right side, first visited the Department of Orofacial Pain and Oral Medicine at Kyung Hee University Dental Hospital with left jaw pain and difficulty in opening mouth and chewing. He had been experiencing difficulties in cognitive function, decrease in visual acuity, impaired speech, and writing deficits after brain surgery. Furthermore, he complained of abnormal occlusion on the right side, which interfered with his ability to chew comfortably and open his mouth effectively. Herein, we describe a contralateral TMD case due to ipsilateral disuse atrophy after brain surgery for a trigeminal schwannoma and our successful treatment with medication, physical therapy, and stabilization splint.

• Journal of Oral Medicine and Pain
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• 제42권3호
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• pp.53-61
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• 2017

Myogenous temporomandibular disorder is a collective term for pathologic conditions of the masticatory muscles, mainly characterized by pain and dysfunction associated with various pathophysiological processes. Among the subtypes of myogenous temporomandibular disorder, myofascial pain is one of the most common muscle disorders, characterized by the presence of trigger points (TrPs). Various modalities, such as ultrasound, manipulative therapy, spray-and-stretch technique, transcutaneous electrical nerve stimulation, injection/dry needling, and low-level laser therapy are used to inactivate TrPs. Needling/injection on the TrPs is one of the most common treatments for myofascial pain. Despite the evidence, there is continued controversy over defining the biological and clinical characteristics of TrPs and the efficacy of injection/dry needling. This review discusses the current concept of injection/needling to relieve TrPs.

• 한국어병학회지
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• 제35권2호
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• pp.167-176
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• 2022

We injected infectious myonecrosis virus (IMNV) to pacific whiteleg shrimp, Litopenaeus vannamei, and observed closely with using light microscope and transmission electron microscope (TEM) for 4-8 days post infection (dpi). As clinical signs, abdominal bodies had mild opaque muscles at 5 dpi. And the mortality was shown at 6 dpi. At 8 dpi, most injected shrimps had severe opaque muscles and humped back that cause of movement disorder. As results of histopathological examinations, local parts of abdominal body muscle had muscle fiber hyalinization, muscle fiber atrophy, rounded muscle fibers, myofibrillar hypertrophy in size, a decrease in number of myofibrils and phagocytosis from the sarcolemmas by multiple hemocytes at 4 dpi. Especially, myofibrillar hypertrophy appeared at the whole or random part of single muscle fiber not in specific locations like the center or edge of muscle fiber. At 6-7 dpi, multiple muscle necrosis, muscle fiber segmentation, myofibril lysis ap- peared and a few hemocytes were infiltrated at lesions. At 8 dpi, extensive muscle necrosis, multiple myofibril lysis and muscle fiber atrophy were shown, and very few hemocytes were infiltrated. In early stage of infection, local viral myositis with zenker's degeneration were shown. These lesions appeared multiply after the early stage. In late stage of infection, extensive coagulative muscle necrosis appeared with few of inflammatory response such as hemocytes infiltration. The lack of hemocytes infiltration response at the late stage might be disadvantage for Litopenaeus vannamei to defense against IMNV and to recover, because hematocytes (granulocyte, semi-granulocyte) eliminate pathogen and damaged tissues from infection sites and help recover. As results of the TEM observation, IMNVs that had nonenveloped icosahedral capsid which was 30-40 nm diameter were in myofibril and beside tubules of sarcoplasmic reticulum and moved to the certain direction. The micro-tears and micro-trau- mas in myofibrils caused muscle fiber necrosis. And semi-granulocytes engulfed IMNVs to eliminate virus.

• 근관절건강학회지
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• 제7권1호
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• pp.102-130
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• 2000

The aims of this study were to understand and to predict the determinant factors affecting the exercise behaviors and physical fitness by testing the Ponder's health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continuous exercise program, and to help them maximize the physical effect such as muscle strength. endurance, and fuctional status and mental effects including self efficacy and quality of life, and improve the physical and mental wellbeing, and to provide a basis for the nursing intervention strategies. We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul between October 5, 1999 and October 24, 1999. Data were composed of self reported questionnaire and good of fitness score which were obtained by pedalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. 24 Of 54 hypothetical paths were supported in modified model, which was considered as a proper model with improved fit index. The physical fitness was directly influenced by exercise participation behavior and education level, and indirectly by physical fitness, while fatigue, physical disability, pastexercise behavior, life-style, self-efficacy, which explained 20% of physical fitness. The exercise participation were directly influenced by perceived benefits and self-efficacy, and indirectly influenced by life-style, fatigue and physical disability, and directly and indirectly by past exercise behavior, which explained 53% of exercise participation. Exercise score were directly affected by perceived health status, perceived benefits, self efficacy, and past exercise behavior, and were indirectly affected by fatigue, physical disability, and life-style, which explained 50%. Perceived health status were directly influeced by level of education, depression, sleep disorder, and physical disability, which explained 34% of perceived health status. Perceived benefit was directly influenced by fatigue, sleep disorder, physical disability, and life-style, which explained 45%. Perceived barriers was directly influenced by fatigue, sleep disorder, and lifestyle, which explained 9%. Self- efficacy was directly influenced by fatigue, physical disability, past exercise behavior, and level of education, which explained 61%. In conclusion, important variables for physical fitness were exercise participation and level of education, and variables affecting exercise participation were perceived self-efficacy, benefits, and past exercise behavior. Perceived self-efficacy of exercise was a significant predictor of exercise participation. Life-style, fatigue, and physical disability showed direct effects on perceived benefit, perceived barriers, and self-efficacy, and indirect effects on exercise behavior. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be soaked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved.

• 한국운동역학회지
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• 제21권2호
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• pp.243-252
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• 2011

The purpose of this study was to determine the effect of trunk posture on muscle activity and motion of scapular and scapulohumeral rhythm. Thirty-one healthy subjects performed right-arm abduction and adduction along the frontal plane while standing in both upright and flexed posture of trunk. Scapular upward rotation, anterior tilting and internal rotation ware recorded using a motion analysis system and muscle activity of upper trapezius, lower trapezius and serratus anterior ware recorded using surface electromyography during abduction and adduction in both trunk postures. then, scapulohumeral rhythm was calculated. Scapulohumeral rhythm and scapular posterior tilting in flexed posture was significantly decreased than in upright posture. Also, muscle activity of lower trapezius in flexed posture was significantly increased and serratus anterior was significantly decreased than in general posture. The result of this study revealed that flexed posture of trunk altered the muscle activity and kinematic of scapular. Measurement of trunk posture should be included the evaluation of dysfunction and disorder of shoulder girdle since rehabilitation of trunk posture is important to restore of upper limbs function.